Individual
NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1400 SAINT GEORGES AVE APT 303, AVENEL, NJ 07001-1188
(917) 868-1390
Mailing address
1400 SAINT GEORGES AVE APT 303, AVENEL, NJ 07001-1188
(917) 868-1390
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
027568-1
NY
Other
Enumeration date
04/17/2019
Last updated
04/16/2021
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